In 1998 I woke up in the emergency room at Lions Gate Hospital in North Vancouver. It was right after my suicide attempt. I'm not going to describe the attempt, here or anywhere. What I want to tell you about is what came next: a conversation with the psychologist on duty in the ER, and the choice I made at the end of it. I chose to stay. I admitted myself, and I spent about a month there.
So, the question I'd have typed into a search bar if I'd been able to think straight. Can you check yourself into a psychiatric hospital? Yes. You can ask to be admitted as a voluntary patient. It usually happens through an emergency room, sometimes through a referral from your doctor. A doctor assesses you and decides if you need a bed. Voluntary means you agreed to be there.
Can you really check yourself into a psychiatric hospital?
You can ask. Getting a bed is a medical decision, and beds are tight almost everywhere. The team admits people when they think the hospital is the safest place for them right now. If they don't admit you, that isn't a verdict on how "sick enough" you are. You should leave with a plan, a follow-up, a number. Hold them to that.
In British Columbia, where I was, the rules come from the provincial Mental Health Act. People's Law School puts it plainly: anyone 16 or older can ask to be admitted to a designated mental health facility. In Québec, the routes into public mental-health care include the ER, your family doctor, your CLSC and Info-Social 811, and the public services are free.
Voluntary or involuntary, what's the difference?
Voluntary means you consented. Involuntary means a hospital is keeping someone against their will because they're judged to be a danger to themselves or others due to their mental state. In Québec that's called a garde en établissement. It comes with legal rules and rights, including regular psychiatric reviews and the right to contest it before a tribunal. Éducaloi explains it in plain French.
Mine was the first kind. Nobody signed a form on my behalf. I said yes.
Can you leave if you admitted yourself?
Generally, yes. In BC, a voluntary patient only needs to tell staff they want to be discharged, and in most cases they're free to go, sometimes after signing a form saying they're leaving against medical advice. The catch: if the team believes you're in serious danger, they can assess you for an involuntary admission instead. That process has its own legal rules.
The details change from one province, state or country to the next. Ask about it on day one. I'd rather you know how it works going in than find out on the ward.
The conversation in the ER
I won't pretend I remember it word for word, and I'm not going to invent it for you. What I know is how it ended. The psychologist talked with me, and when we were done, I chose to admit myself. Voluntary. Straight from the ER.
I've only understood this part in the last few years, mostly through therapy. My whole life, I've left before I could be left. Jobs, cities, people. In that ER I did the opposite. I stayed put and let strangers see me at my worst.
I didn't know I had ASD back then. That came at 50, twenty-four years later. In 1998 I just knew my head was too loud and I'd run out of ways to manage it.
What a month on a psych ward looked like for me
About a month. Group therapy. Different kinds of counselling. Therapy. Medication, which I'm not going to name, because what I was given in 1998 tells you nothing about what you need. That's a conversation for your doctor or pharmacist.
None of it was dramatic. The days had a structure, and there were people whose job was to help me. That was what I needed right then. If you want the inside view (the routine, the rules, the other patients), I wrote what a psych ward is really like, and a practical list of what to bring to the psychiatric hospital.
If you're thinking about asking for a bed
Go to the ER and tell the truth at triage. Something like "I'm having thoughts of killing myself" or "I can't keep myself safe." It can come out flat or weird. You might laugh while you say it. Autistic people especially, we don't always look like we're in crisis. Say the words anyway. They go by what you tell them. Bring someone if you can.
If you're not sure you need the hospital tonight, call a crisis line first. They won't admit you, but they can help you figure out the next step and stay on the phone while you do. In Québec that's 1 866 APPELLE (1-866-277-3553), text 535353, or chat on suicide.ca. 988 works across Canada and the US (in Québec, 988 calls get transferred to 1 866 APPELLE). Info-Social 811, option 2, is there 24/7 in Québec too. I wrote about what actually happens when you call a crisis line, because I know the fear of picking up the phone.
If you're in immediate danger, call 911.
Was it worth it?
Yes.
The month didn't fix me. I hate stories where one big moment cures the guy, so I'll be straight. It stopped the fall. That was enough to start from.
The years after were messy. Depression. Substance use. I haven't touched cocaine or heroin since 2010, sixteen years now. Then a breakdown in the COVID years, and a social worker who actually cared, who helped me get support and a diagnosis. I'm still here, writing this from a house in the woods with Sandra, my partner, who puts up with me. If you want the long version, it's in life after my 1998 attempt.
Saying yes in that ER was the first step of all of it.